Manual Processes Continue to Bog Down Productivity in Decontamination

Productivity is a central measurement in sterile processing departments, particularly in decontamination. The potential for bottlenecks in processes and lost productivity is at its highest in decontamination due to the sheer quantity of tasks and manual labor involved. It’s no wonder why managers look to decontamination when it comes time to fuel productivity boosts. Identifying these opportunities, however, can be tough. That is, until you start looking at manual processes.

Manual processes have an inherent ability to bog down productivity due to their very nature: they’re physical labor intensive, done by a range of people with varying experience levels and wide open to potential human error and inconsistency. What manual processes should managers zero-in on when it comes to identifying potential productivity drainers?

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Manual Rinsing & Flushing

Rinsing and flushing are key contributors to lost productivity in decontamination. In fact, a Process (previously Communique) analysis, A Glimpse at the True Cost of Reprocessing Endoscopes: Results of a Pilot Project, into endoscopy reprocessing found that the manual cleaning step takes 17.3 minutes1. One area where time is spent: syringe flushing. Syringe flushing leads to diminished productivity for a few reasons:

1. Time: Syringe flushing is a slow, arduous process that lengthens the time necessary to achieve IFU compliance due to the multiple steps required and limited syringe volume capacity.
2. Human error: Each technician is unlikely to execute syringe flushing the exact same way. This human error means that some teammates are bound to be less efficient at it than others.
3. Ergonomics: Syringe flushing is a tiring process, and this is only amplified over the course of an entire shift. As the day goes on, technicians are likely to begin feeling the strain syringe flushing causes, which results in altered syringing methods that can lead to poor flushing performance, and an amplified impact of human error. Inability to achieve IFU compliance towards the end of the day could mean lumened instruments need to be reprocessed a second time later, effectively doubling the time it takes to adequately reprocess them.

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Manual Measurement, Mixing, and Dispensing of Chemistries

Manually preparing enzymatic detergents and disinfectants for instrument decontamination is a time-consuming and error-prone process that can negatively impact both efficiency and cleaning efficacy. Sources of lost productivity related to these activities include:

1. Inconsistent dilution ratios: Manually measuring and dispensing these chemicals often leads to over/under-concentrated solutions. This can negatively impact cleaning performance and ultimately the quality of outcomes.
2. Lost time: Manually filling basins, measuring chemicals and mixing solutions before placing instruments in them present several steps’ worth of wasted time that a technician could be using to conduct other tasks.
3. Wasted chemistries and restocking: Inaccurately mixed solutions can result in over-use of certain chemistries, not only driving up costs associated with them, but wasting technicians’ time leaving the sink, finding the chemistry, and replacing it. Over time, these actions can add up.
4. Risk of chemical exposure: While more loosely tied to productivity, it is worth mentioning that the more a team is required to handle and mix chemicals, the more likely it becomes that they experience negative consequences as a result of it. These can include risk of skin exposure, inhalation, and spills, all of which can result in the temporary loss of teammates and potential impacts on productivity for the department.

Unassisted Visual Inspection

The human eye is a marvel, to be sure. But one deficiency it has is an inadequate ability to detect bioburden and other debris without assistance. Visual inspection is a key responsibility for sterile processing technicians before moving them out of decontamination for sterilization. Visual inspection without the assistance of magnification or enhanced illumination can lead to several productivity challenges:

1. Incomplete detection: Many contaminants, such as dried blood, bone fragments and tissue are particularly difficult to identify under standard lighting conditions. Further, small cracks and crevices in instruments can harbor residue that the human will simply never be able to pinpoint on its own. If these are missed in decontamination, they will need to be sent back and effectively reprocessed twice.
2. Technician fatigue: Conducting visual inspection without assistance of magnification or enhanced illumination puts a tremendous amount of not only physical strain on technicians’ eyes, but also cognitive strain on the mind from intense focus over long periods of time. Both forms of strain impact the quality of work and the efficiency of it. As these strains grow over the course of a shift, productivity will suffer.

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Productivity is a measure that managers, directors, and other leadership positions look at to gauge departmental performance. Assessing manual processes that contribute to productivity metrics is a smart way to begin positively changing them.

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Interested in learning about how to start booting productivity by tackling manual processes? Check out this blog post!

Sources

1 Boston Scientific. (n.d.). Sterilization resource handout. Retrieved [2.13.25], from https://www.bostonscientific.com/content/dam/bostonscientific/uro-wh/portfolio-group/LithoVue/pdfs/Sterilization-Resource-Handout.pdf